title: Tumour expresion of tissue factor and tissue factor pathway inhibitor in ovarian cancer- relationship with venous thrombosis risk.
abstract: BACKGROUND
  Ovarian cancer is known to display a particular association with venous thromboembolism (VTE) with reports up to 42% of patients developing thromboembolic complications. Tissue Factor (TF) and its inhibitor Tissue Factor Pathway Inhibitor (TFPI) have been implicated in VTE risk in cancer. The aim of this study was to measure tumour derived TF and TFPI and to investigate their potential role in VTE in ovarian cancer patients.
  
  
  METHODS
  TF and TFPI mRNA expression was measured using TaqMan real time PCR in 99 ovarian tumour samples. Nineteen cases complicated by VTE were matched to 19 cases without VTE. TF and TFPI protein levels were measured using ELISA and immunohistochemistry was used to localize TF expression. The role of TF expression on overall survival was also determined.
  
  
  RESULTS
  TF mRNA and protein expression was increased in tumours from patients with clear cell carcinoma (p<0.001). TF protein expression was also increased in endometroid carcinoma (P<0.01) compared with benign tumours. TFPI mRNA expression was increased in clear cell carcinoma (P<0.01). TF mRNA and antigen level was increased in malignant tumours of patients who developed VTE compared with matched malignant õtumours of patients who remained thrombosis free (P<0.01). There was no difference in TFPI expression between the two groups.
  
  
  CONCLUSIONS
  TF expression in ovarian cancer is significantly higher in patients who develop VTE. TF expression was increased in clear cell ovarian cancer and endometroid cancer and this may explain the higher risk of VTE in these subgroups. TF derived from these tumours may be the trigger for VTE in ovarian cancer.
authors.affiliation: Department of Obstetrics and Gynaecology, Trinity College Dublin, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland. Electronic address: ferasabusaadeh@dubgyn.org.
authors.forename: Feras
authors.initials: F
authors.lastname: Abu Saadeh
authors.forename: Lucy
authors.initials: L
authors.lastname: Norris
authors.forename: Sharon
authors.initials: S
authors.lastname: O'Toole
authors.forename: Bashir M
authors.initials: BM
authors.lastname: Mohamed
authors.forename: Ream
authors.initials: R
authors.lastname: Langhe
authors.forename: John
authors.initials: J
authors.lastname: O'Leary
authors.forename: Noreen
authors.initials: N
authors.lastname: Gleeson
mesh_terms: D000368:Aged; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008074:Lipoproteins / Q000032:analysis / Q000235:genetics*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications* / Q000235:genetics* / Q000473:pathology; D010053:Ovary / Q000473:pathology; D012333:RNA, Messenger / Q000235:genetics; D013925:Thromboplastin / Q000032:analysis / Q000235:genetics*; D015854:Up-Regulation; D020246:Venous Thrombosis / Q000209:etiology* / Q000235:genetics
chemical_list: D008074:Lipoproteins; D012333:RNA, Messenger; C051928:lipoprotein-associated coagulation inhibitor; D013925:Thromboplastin
keywords: Tissue factor; VTE; clear cell carcinoma